Tuebinger evaluation of Risk factors for Early detection of NeuroDegeneration

The occurrence of specific symptoms that allow the clinical diagnosis of Parkinson's and Alzheimer's disease is preceded by a long prodromal phase in which the
neurodegenerative process leads to substantial neuronal loss. To enable an earlier disease-modulating or even neuroprotective therapy it is essential to identify, characterize and validate risk
and prodromal markers for Parkinson’s and Alzheimer’s disease.

Background information about the TREND study

Parkinson’s and Alzheimer’s disease are common severe and chronic diseases. The appearance of specific symptoms that allow the clinical diagnosis of Parkinson's and
Alzheimer's disease is preceded by a long prodromal phase in which the neurodegenerative process leads to substantial neuronal loss. To date, it is not exactly known why and how this
happens.

Symptoms as risk factors – early detection is very important

The neurodegenerative process in the prodromal phase is associated with several symptoms that may indicate an increased risk for Parkinson’s or Alzheimer’s
disease.

These symptoms include:

Ultrasound abnormalities like substantia nigra hyperechogenicity as a vulnerability marker for Parkinson’s disease

autonomic dysfunctionThese may be markers for the prodromal state of these diseases but are not specific.

Thus, the majority of people with these symptoms will never develop Parkinson's or Alzheimer's disease.

Nevertheless, these clinical and imaging markers have previously been implicated in (early stages of) Parkinson's disease or dementia and, thus, assessment of these
markers may indicate a risk for the development of these diseases. Therefore, these and other (bio-)markers are assessed regularly in the TREND study to evaluate their predictive value for a
neurodegenerative disease.

Aims of the study

The
major aim of the TREND study is to collect data concerning these markers BEFORE Parkinson’s and Alzheimer’s Disease is diagnosed. We believe that the insights we get will enable earlier
intervention or even neuroprotective therapy in individuals at prodromal stages of these diseases. Therefore, approximately 1200 individuals with a specific risk profile (see below) aged over 50
years at baseline are assessed every two years with a comprehensive, mainly quantitative assessment battery.